IBM Voluntary Community Assistance Network V-CAN User manual

INDIANA ELIGIBILITY MODERNIZATION
Voluntary Community Assistance Network (V-CAN)
V-CAN User Guide [email protected]
V-CAN User Guide
December 2008

INDIANA ELIGIBILITY MODERNIZATION
Voluntary Community Assistance Network (V-CAN)
V-CAN User Guide 2 [email protected]
Table of Contents
1. Getting Started………………………………………………………………………………….. 3
2. Applying for Benefits in the New System…………………………………………………... 5
2.1 its Overview
n Process After Modernization
g
ation
acket
epresentatives
lication Processes
……………….. 20
ion
Status
ime)
After-Hours Automated System)
4. Client Support Materials……………………………………………………………………… 26
aterials ials
5. V-CAN Resources……………………………………………………………………………… 28
5.1 General
5.1.1 V-CAN Publications and Documents
5.1.2 V-CAN Member Questions
5.1.3 Instructions for Locating the Online Functions
6. Appendix …………………………………………………………………………………………30
6.1 Quick Reference Cards
6.1.1 Public Assistance Contacts
6.1.2 Call Center Main Menu (business and after-hours)
6.1.3 Indiana Benefits: Information to Get You Started
1.1 Introduction
ide1.1.1 V-CAN User Gu
1.1.2 Options for Access Points
Applying for Benef
2.1.1 Applicatio
2.1.2 Internet Screenin
2.1.3 Online Applic
2.1.4 Call Center
2.1.5 Paper Application
2.1.6 Application P
2.1.7 Submitting an Application
rocessing2.1.8 Application P
2.1.9 Interviews
2.1.10 Authorized R
2.1.11 Other App
2.1.12 Application Tips
3. Managing Benefits in the New System……………………………………
iew3.1 Managing Benefits Overv
strat3.1.1 Agency Regi
3.1.2 Checking Case
3.1.3 Reporting Changes
3.1.4 Redetermination
3.1.5 Call Center Main Menu (7am - 7pm, Monday – Friday, local t
3.1.6 Call Center Main Menu (
4.1 Client Support Materials Overview
oint Materials4.1.1 Access P
4.1.2 Referral Member M
4.1.3 How to Order Client Support Mater

INDIANA ELIGIBILITY MODERNIZATION
Voluntary Community Assistance Network (V-CAN)
V-CAN User Guide 3 [email protected]
1.1. mily Resources (DFR) is
ing the way Hoosiers apply for Cash Assistance (TANF), Food Stamps and Health Coverage
d on a regional basis
their public
th Eligibility Modernization, the Voluntary Community Assistance Network (V-CAN) is a
ion about and
d Stamps and Health
ir clients – whether it is just to
mputer or phone to apply
r manage benefits.
hen assisting applicants
anage benefits in the
e tools they offer in their
ide may not apply to all V-CAN Access
ou have not
N Training presentations posted on the FSSA
1. Getting Started
Introduction
The Indiana Family and Social Services Administration (FSSA) Division of Fa
improv
(Medicaid and Hoosier Healthwise). Eligibility Modernization is being implemente
throughout Indiana to provide more choices for Hoosiers to apply for and manage
assistance.
In conjunction wi
formal network of service providers and community organizations that provide informat
access to the new tools available to apply for Cash Assistance (TANF), Foo
Coverage. V-CAN members can choose to provide any kind of help to the
get up-to-date information about system changes or to offer access to a co
for o
The V-CAN User Guide serves as a desk-top reference for V-CAN Access Points w
and clients in their office. This guide provides tips on the ways to apply for and m
new system. Depending on an Access Point’s level of involvement (i.e., th
e) and client needs, the information contained in this guoffic
Points.
The V-CAN User Guide is intended to supplement, not replace, V-CAN Training. If y
attended a V-CAN Training session, please review the V-CA
website (www.in.gov/fssa, click “Eligibility Modernization” and “Communications”
of the V-CAN User Guide is also available on the FSSA website. If you have questi
information contained in this guide, please contact us at
). An electronic copy
ons about the
[email protected].
1.1.1 V-CAN U
The V CA to assist V-CAN members with the new
system: Applying for Benefits in the New System, Managing Benefits in the New System, Client Support
Materials, V-CAN Resources, and an Appendix with Quick Reference Cards.
Throughout the guide, there are tips for using the new tools to apply for and manage benefits in the
new system. These tips may be especially helpful for V-CAN Access Points, Authorized Representatives or
clients. These tips are identified throughout the User Guide with an arrow and text box as shown below:
ser Guide
N User Guide is organized into five primary sections-
Throughout the document, helpful tips for using the new tools to apply for or
manage benefits in the new system are identified in this text box.

INDIANA ELIGIBILITY MODERNIZATION
Voluntary Community Assistance Network (V-CAN)
1.1. participation. V-CAN
2Options for Access Points
The first step to becoming a V-CAN Access Point is to determine your level of
membership is completely voluntary and you can choose
resource t needs. There is no one-size-fits- the level of access that fits your available all approach to V-CAN membership. If you are a V-
are some options for consideration:
eof the following:
Computer
- Internet (Internet Explorer 6.0 or Netscape 7.0 - Free download)
ad)
puter, phone, etc.) that
ublicized Access Points serve the public and are listed on the FSSA website as
locations where applicants and clients can visit to apply for or manage benefits. To
w.in.gov/fssa
s and clien
CAN Access Point or are considering becoming one, below
A Access Point will provide at least onno
- Adobe Acrobat Reader version 4.0 or newer (Free downlo
- Printer (Optional, if computer is provided)
oPhone
oFAX
oMail
Access Points can choose to provide the method(s) of access (com
make sense for their clients and available resources.
Access Points can choose to be publicized or non-publicized.
9P
find a list of Publicized Access Points in your county, go to ww , click
our county.
ny or all of the new tools for their
existing clients only. Non-publicized Access Points will not be listed on the FSSA
website.
“Family Resources” and “Where do I apply?”, then select y
9Non-publicized Access Points provide access to a
•You can upgrade your V-CAN member status at any time. If you would like to
upgrade to an Access Point or update your status as publicized or non-
publicized, email us at [email protected].com.
•Non-publicized Access Points will not be listed on the FSSA website.
V-CANUserGuide 4 [e-mail]

INDIANA ELIGIBILITY MODERNIZATION
Voluntary Community Assistance Network (V-CAN)
V-CAN User Guide 5 [email protected]
2.1 w system. Applicants can complete
application, start an application over the phone with a Call Center
application or through
ts.
2.1.1 after modernization starting with each entry point
(i.e., toll-free line, local DFR office and Internet) and how an application and supporting documents are
submitted and processed. This diagram can be used as a reference for V-CAN members who assist
clients with the application process.
Figure 1: Public Assistance Application Process After Modernization
2. Applying for Benefits in the New System
Applying for Benefits Overview
There are several ways applicants can apply for benefits in the ne
an Internet screening and online
Representative, or apply at a local DFR office using a computer, phone, paper
an in-person interview. This section highlights each method of applying for benefi
Application Process After Modernization
The diagram below shows the application process

INDIANA ELIGIBILITY MODERNIZATION
Voluntary Community Assistance Network (V-CAN)
Depending on t
Application), there are multiple w o s;
he different entry point (i.e., Internet, Online Application, Call Center or Paper
2.1.
ÖElectronic Signature
ening (similar to the FSSA QualCheck system used prior to
l questions related to
e screening indicates
ant’s screening results
DFR office or call the
s may receive Food Stamps
within seven days of the application date.
When an applicant completes all sections of the screening, s/he will view a results page (see Figure 2:
Screening Results). The results page tells the applicant whether s/he may or may not be potentially
eligible for Food Stamps, Cash Assistance (TANF) or Health Coverage (including the Healthy Indiana
Plan (HIP). Upon completion of the screening, applicants can choose how they want to apply for
benefits. Regardless of the screening results, an applicant may apply for any or all of the public
assistance programs. NOTE: The screening results are not an official eligibility determination. Eligibility is
determined by a State Worker after a signed application is submitted to the FSSA Service Center.
ÖElectronic Signature
Paper Application
l ÖPaper Application
ctronic Signature
n
ays t apply for benefit
ÜOnline Application
Internet Screening ÖPrint Ö
ÞMai
Online Application ÖEle
Call Center ÖMail ÖPaper Applicatio
Pap r Application ÖSigna
eture Page
2 Internet Screening
Applicants have the following options when completing the Internet screening:
ÜOnline Application
Internet Screening ÖPrint ÖPaper Application
ÞMail ÖPaper Application
Step 1: Internet Screening
Applicants will complete the scre
modernization) available in English or Spanish. The screening contains genera
household members, relationships, resources, income and expenses.
Applicants should complete the screening prior to completing an application. Th
whether the applicant may be eligible for Expedited Food Stamps. If an applic
indicate potential eligibility for Expedited Food Stamps, s/he should visit a local
FSSA Call Center. Applicants potentially eligible for Expedited Food Stamp
V-CANUserGuide 6 [e-mail]

INDIANA ELIGIBILITY MODERNIZATION
Voluntary Community Assistance Network (V-CAN)
Figure 2: Screening Results
Step 2: Ap
After scree ance (TANF), Food Stamps and/or Medicaid. The
general household, resources, income and expenses information entered into the Internet Screening will
plicants may continue answering questions on
paper application, or
:
ature
ÞMail ÖPaper Application
Option 1: Internet Screening ÖOnline Application ÖElectronic Signature
If an applicant chooses to complete the online application, s/he will continue answering questions
related to household, resources, income and expenses online. Before starting the online application, a
10-digit confirmation number will be provided to the applicant. The applicant should write down the
confirmation number before starting the online application. If an applicant cannot finish the online
in one sitting, s/he can use the confirmation number to finish the application when time
permits. The applicant will enter the confirmation number into the “Returning User? Enter Confirmation
Number” box contained at the beginning of the online application.
ply for Benefits
ning, applicants can apply for Cash Assist
be auto-filled into a partially-completed application. Ap
a computer by completing the online application, print a partially-completed
request a mailed, partially-completed application. Each process is outlined below
ÜOnline Application ÖElectronic Sign
Internet Screening ÖPrint ÖPaper Application
application
V-CANUserGuide 7 [e-mail]

INDIANA ELIGIBILITY MODERNIZATION
Voluntary Community Assistance Network (V-CAN)
Figure 3: Online Application Returning User
n online application once it is started and saved. Once an
ing an electronic signature
s the online application,
packet contains a summary of
rsheet and a Summary of Rights and
Responsibilities. The applicant will gather copies of supporting documents and submit the documents to
the FSSA Service Center or to a local DFR office.
Option 2: Internet Screening ÖPrint ÖPaper Application
After the screening, an applicant can print a partially-completed paper application containing the
information entered into the screening. On the paper application, the applicant will answer more
questions about household, resources, income and expenses. When complete, the applicant will sign
the Indiana Application for Assistance signature page and submit it with copies of supporting
documents (see Section 6.1.3) to the FSSA Service Center or local DFR office.
Applicants will have 30 days to complete a
applicant completes the online application, s/he will sign the application us
(see Section 2.1.3, Figure 7: Electronic Signature). Once the applicant complete
s/he will print or request a mailed copy of the application packet. This
the online application responses, a Document Cove
V-CANUserGuide 8 [e-mail]

INDIANA ELIGIBILITY MODERNIZATION
Voluntary Community Assistance Network (V-CAN)
Figure 4: Partially-completed Paper Application
If a pri ening, s/he can request
cation. Once the paper
te the application, sign the Indiana
Application for Assistance signature page and submit the application with copies of supporting
documents (see Section 6.1.3) to the FSSA Service Center or local DFR office.
JANE SMITH
123 MAIN STREET
MARION IN 46952
JANE SMITH
123 MAIN STREET
MARION IN 46952
The application is
ially-completed with
household member
information provided
during the Internet
Screening.
part
Option 3: Internet Screening ÖMail ÖPaper Application
nter is not available at the computer where the applicant finishes the scre
the partially-completed application be mailed to his/her home or another lo
application is received by mail, the applicant will comple
•It is recommended, not required, that applicants complete the screening prior to
completing the online application. The screening helps identify applicants potentially
eligible for Expedited Food Stamps, so all applicants are encouraged to complete the
screening prior to applying for public assistance.
•An application, regardless of the method used to apply (i.e., toll-free line, local DFR
office or Internet), is considered submitted when the Indiana Application for Assistance
signature page is received at the Service Center or local DFR office.
V-CANUserGuide 9 [e-mail]

INDIANA ELIGIBILITY MODERNIZATION
Voluntary Community Assistance Network (V-CAN)
2.1. If an applicant is not applying for Food Stamps, or does not wish to screen for potential eligibility of
Exp dite Foo ening and complete the online application.
eting the online application:
plication
online application by answering questions about household members,
relationships, resources, income and expenses. The figures below provide examples of the household
member screens of the online application. Applicants will enter general information about each
household member as shown below:
Figure 5: Household Member Information
At the end of each online application section, applicants will review a summary page which allows the
applicant to review what is entered into the application and make changes if necessary. Applicants
will have 30 days to complete an online application once it is started and saved. Figure 6 shows the
Household Member Information Summary.
3Online Application
e d d Stamps, s/he can bypass the Internet Scre
There are two steps to compl
Online Application ÖElectronic Signature
Step 1: Complete Online Ap
An applicant will complete the
V-CANUserGuide 10 [e-mail]

INDIANA ELIGIBILITY MODERNIZATION
Voluntary Community Assistance Network (V-CAN)
Figure 6: Household Member Information Summary
plication
When an applicant completes the online application, s/he will sign the application using the electronic
signature. If the applicant does not want to use an electronic signature, s/he may print a copy of the
application, filled in with the information provided during the online application, sign the Indiana
Application for Assistance and submit the signature page to the FSSA Service Center. Figure 7 shows the
electronic signature page of the online application:
Figure 7: Electronic Signature Page
Step 2: Sign and Submit Ap
V-CANUserGuide 11 [e-mail]

INDIANA ELIGIBILITY MODERNIZATION
Voluntary Community Assistance Network (V-CAN)
V-CANUserGuide 12 [e-mail]
Once the applicant signs the application, s/he may print or request a mailed copy of the application
packet. This packet will contain a summary of the online application responses, a case-specific, bar-
ocument Coversheet and a Summary of Rights and Responsibilities. The applicant will submit
2.1. Call Center
Another way to ap d Stamps and Health Coverage is to start an
e. The process for starting an application
applicant begins an application by answering screening questions about household members,
the phone with a Call Center Representative. The
er the phone and will
ning, the FSSA Service
plicant.
ail. The application packet will contain the
partially-completed ce, Indiana Application for Assistance signature
mmary of Rights and Responsibilities. The applicant will sign the
signature page and submit it with copies of supporting documents to
th l DFR office.
2.1.5 Pa
If pre a blank paper application at a local DFR office or at a V-CAN Access
Point tion are below:
per Application ÖSignature Page
o to www.in.gov/fssa
Click the "Apply For Benefits/Manage Your Benefits" button
Select your county
Click "Start Here" (or "Versión en Español" for Spanish)
Click "Apply for Benefits"
Select program(s) – TANF, Food Stamps, Health Coverage
Enter name and address of applicant
Click "Print Application”
Step 2: Sign and Submit Paper Application
When an applicant completes the application, s/he will need to sign the Indiana Application for
Assistance signature page and submit it with copies of supporting documents to the FSSA Service
Center or local DFR office.
coded D
copies of supporting documents to the FSSA Service Center or local DFR office.
4ply for Cash Assistance (TANF), Foo
application over the phone with a Call Center Representativ
through the Call Center is outlined below:
Call Center ÖMail ÖPaper Application
answers screening questions with a Call Center RepresentativeStep 1: Applicant
An
relationships, resources, income and expenses over
Call Center Representative will complete the screening with the applicant ov
discuss the screening results with the applicant. Upon completion of the scree
Center mails a partially-completed application and application packet to the ap
Step 2: Applicant completes, signs and submits application
An applicant receives the application packet in the m
Indiana Application for Assistan
page, Document Coversheet and Su
Indiana Application for Assistance
e FSSA Service Center or loca
per Application
ferred, applicants can print
location. The steps for printing a blank paper applica
Pa
Step 1: Print and Complete Paper Application
G

INDIANA ELIGIBILITY MODERNIZATION
Voluntary Community Assistance Network (V-CAN)
V-CANUserGuide 13 [e-mail]
6 Application Packet
An applicant may print or have an application packet mailed to them, regardl
start an application (i.e., toll-free number, local DFR office or Internet). If an ap
screening and print
The application contains a case-
s
pecific barcode, so a blank paper application
should not be photocopied and used for multiple applicants.
2.1. ess of method used to
plicant completes the
s a partially-completed application or requests one to be mailed, s/he will receive
and signature page,
upporting documents
e the partially-
If an applicant completes the online application, the applicant’s responses are entered into the online
end of the online application, the applicant can print or request a mailed
s. In addition to the
Summary of Rights and
red for each program
2.1. ents can be submitted to the FSSA Service
f at a local DFR office.
date and will send
.
hould be used when submitting copies of
supporting documents after the application has already been submitted, whether sending by mail or
FAX to the FSSA Service Center. The Document Coversheet may be used more than once for the same
case if you are sending different documents in separate FAXes or envelopes (e.g., the applicant has
some documents one day and brings in additional documents the next day).
Applicants will place an “X” next to the type of supporting document submitted (i.e., copy of vehicle
registration, rent receipt, etc). If sending a completed application and copies of supporting
documentation, be sure to include the application and the supporting documents in the same FAX
transaction to the FSSA Service Center (no Document Coversheet needed, since the application
contains a case-specific, bar-code). See Figure 8: Document Coversheet.
an application packet containing the entire Indiana Application for Assistance
Summary of Rights and Responsibilities, Document Coversheet and a list of s
required for each program. The application contains space for the applicant to complet
completed application.
application. At the
application summary (not the entire application) that contains the response
application summary, the Indiana Application for Assistance signature page, the
Responsibilities, Document Coversheet and a list of supporting documents requi
are provided in the application packet.
7Submitting an Application
Completed applications and copies of supporting docum
Center through the mail or FAX (same as the toll-free number), or dropped of
Local DFR offices will date stamp the application to establish the application
applications and supporting documents to the FSSA Service Center for processing
A case-specific, bar-coded Document Coversheet s

INDIANA ELIGIBILITY MODERNIZATION
Voluntary Community Assistance Network (V-CAN)
Figure 8: Document Coversheet
For the e submitted on an
in se and Social Security
Card, n copying both items on the
same pag
Select the
document(s)
mailed or FAXed
to the FSSA
Service Center.
mo t efficient processing, each piece of required documentation should b
dividual page. For example, if you are providing a photocopy of a driver’s licen
you should copy each document on a separate page rather tha
s
e.
•Once an application and/or supporting documents are submitted by mail or FAX to
the Service Center, the information should not be resubmitted. A document that is
not yet available for processing is not lost; resubmission will slow the system down,
creating multiple copies of the same document.
•Remember: Each Document Coversheet includes a case-specific barcode that is
used to attach the documents to the electronic case file. Do not copy or use a
Document Coversheet for client(s) who are not associated with that case.
•If submitting an application and supporting documents by mail, be sure to remove all
paper clips and staples.
V-CANUserGuide 14 [e-mail]

INDIANA ELIGIBILITY MODERNIZATION
Voluntary Community Assistance Network (V-CAN)
2.1. An application is considered submitted when the Indiana Application for Assistance signature page is
signed e signed application is received, the FSSA
Serv for each program:
d Food Stamps
d Hoosier
ed Representatives should not check on the status of an application until the
ice is received in the mail.
The 2032 ting documents need
to be su application processing
copies of supporting documents with the application in a FAX or mailed
packet t the FSSA Service Center.
2.1. nd Health Coverage
in-person application
ircumstances such as
equire a face-to-face
se who face hardship
n effect in the new system. Food Stamp interviews will be conducted in
two phases. An Eligibility Specialist (Coalition Worker) will conduct the first part of the interview and a
State Worker will complete the second part of the phone interview and determine eligibility.
Once a signed application is received and reviewed at the FSSA Service Center, an appointment
notice will be mailed to the applicant with the interview date and time. Phone interviews are scheduled
during a two-hour window to maximize the number of interviews completed in a work day. If an
applicant does not have a phone number on file, a phone interview will be scheduled in the local DFR
office. If needed, the applicant may call the FSSA Service Center between 7am and 7pm, Monday –
Friday, to reschedule the interview appointment. An applicant has 30 days after the application is filed
to reschedule an interview appointment.
8 Application Processing
and received by the FSSA Service Center. Once th
ice Center will follow the application processing standards defined
7 days for Expedite
30 days for Food Stamps and Cash Assistance (TANF);
45 days for Medicaid (including the Healthy Indiana Plan an
Healthwise); and
90 days for Disability Medicaid
/or AuthorizApplicants and
application processing time has passed or a 2032 Pending Verifications not
Pending Verifications notice will be mailed to an applicant when suppor
bmitted in order to process the application. In order to improve the
ke sure to includetime, ma
o
Interviews
If a case closure or denial decision is found to be in error or missing
case closure may be rescinded. If a client submits all required doc
date and the documents are not processed in a timely manner, the
date will be restored.
a document, the
uments by the due
original application
9Interviews are required for most Cash Assistance (TANF), Food Stamp a
applications. Interviews are typically conducted over the phone; however,
interviews may be conducted at the applicant’s request or due to individual c
personal needs or program complexity. Food Stamp applications generally r
interview; however, the Food Stamp policy allowing phone interviews for tho
traveling to an office remains i
V-CANUserGuide 15 [e-mail]

INDIANA ELIGIBILITY MODERNIZATION
Voluntary Community Assistance Network (V-CAN)
2.1. A ed by applicants and clients who have barriers to
comp esentatives are designated to perform one or
more of
e (TANF) benefits.
half of the client
in one of the ways listed above (PLEASE NOTE: Authorized Representatives are responsible for the
Policy Manual section
ke any designated staff
r about the information
for more information.
ot an agency or organization. Applicants and clients
may designate up to three Authorized Representatives per program (i.e., Cash Assistance/TANF, Food
Stamps and Medicaid). Authorized Representatives can be designated in the following ways: 1)
Authorized Representative section of the Indiana Application for Assistance (either online or paper
application); or 2) Authorized Representative Form (found at www.in.gov/fssa
10 Authorized Representatives
uthorized Representatives may be designat
leting the application process. Authorized Repr
the following functions:
Apply on behalf of the applicant/client;
Be interviewed on behalf of the applicant/client;
Receive copies of notices; and/or
Report changes and receive information about Cash Assistanc
Authorized Representative status is required only if a staff member will be acting on be
information they provide to the FSSA Service Center. See Indiana Program
2005.05.10). Agency Registration is recommended for an agency that would li
to be able to check case status and speak with the FSSA Service Cente
provided there (once the client signs an appropriate release). See Section 3.1.1
An Authorized Representative must be a person, n
, click “Eligibility Modernization”
and “Communications.”
Figure 9: Authorized Representative section of the online application
9
9
9
9
9
9
V-CANUserGuide 16 [e-mail]

INDIANA ELIGIBILITY MODERNIZATION
Voluntary Community Assistance Network (V-CAN)
Figure 10: Authorized Representative Form (available on the FSSA website)
2.1.11 Other Application Processes
mps, Cash Assistance
ion processes relevant
he following programs:
•Medicaid Disability; and
•Medicare Savings Program.
Hoosier Healthwise
To apply for Hoosier Healthwise, applicants can complete the Hoosier Healthwise application (State
Form 43202), or complete the Indiana Application for Assistance. When completing the Hoosier
Healthwise application at a Hoosier Healthwise Enrollment Center, make sure to include the Enrollment
Center code and name of the Enrollment Center staff member completing the interview on the paper
application. NOTE: When completing the Hoosier Healthwise paper application, Question 14 labeled
“Assignment of Rights” should be signed when a pregnant adult woman applies for the program. A non-
applicant parent who is applying only for children does not have to sign Question 14.
99
V-CANUserGuide 17 [e-mail]
Applicants may designate up to three Authorized Representatives per program (i.e.,
nce/TANF, Food Stamps and Medicaid).Cash Assista
In addition to using the Indiana Application for Assistance to apply for Food Sta
(TANF) and Health Coverage, there are several other program-specific applicat
to V-CAN members. The following section highlights the application methods for t
•Hoosier Healthwise;
•Healthy Indiana Plan;

INDIANA ELIGIBILITY MODERNIZATION
Voluntary Community Assistance Network (V-CAN)
V-CANUserGuide 18 [e-mail]
Healthy Indiana Plan (HIP)
HIP is a state-sponsored health insurance plan for low-income Hoosiers. Hoosiers who may qu
include: alify for HIP
64; f federal poverty level
PL); adults may be covered); ge;
zen (refugee or asylee);
months.
ay be found online at
•Uninsured, non-disabled adults between the ages of 19-
•Parents or caretaker relatives of dependent children from 22% to 200% o
(F
•Childless adults (maximum of 34,000
•Hoosiers who are ineligible for employer-sponsored health care covera
•U.S. citizens, legal immigrants (for at least 5 years), or a qualified non-citi
and
•Hoosiers who are uninsured for at least 6
To apply for HIP, an applicant may complete a paper HIP application, which m
www.HIP.in.gov. Local DFR offices, Hoosier Healthwise Enrollment Centers and p
also have copies of paper HIP applications. Once completed, a HIP applica articipating V-CAN sites tion may be submitted to a
mplete the Indiana Application
licant must answer “yes” to Question
ocess is listed below:
gned and submitted;
intment notice to the applicant;
;
•conducts interview (by phone, unless in-person is requested);
w
(if documents are
ical Review Team (MRT);
•MRT makes disability determination;
•State worker makes Medicaid eligibility determination; and
•FSSA Service Center mails approval/denial notice to applicant.
Medicare Savings Program
The Medicare Savings Program application is used for specific Medicaid categories: Qualified Medicare
Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB) and Qualified Individual (QI).
To apply, applicants may complete the Indiana Application for Assistance online, over the phone, or
on paper, or complete the Medicare Savings Program paper application (State Form 49228). MSP
applications are processed within 45 days of application date.
local DFR office or to the FSSA Service Center by mail or FAX.
Medicaid Disability (MA-D)
To apply for MA-D, an applicant or Authorized Representative may co
for Assistance. On the Indiana Application for Assistance, the app
12 “Is this person blind, disabled or incapacitated?” The MA-D application pr
•Indiana Application for Assistance is completed, si
•FSSA Service Center mails an Interview Appo
•Applicant gathers medical provider information
FSSA Service Center
Worker coompletes 251B (Social Summary) during interview
oApplicant gives medical provider contact information during intervie
•FSSA Service Center mails: 2032 Pending Verifications Notice to applicant
needed) and 251A to medical provider;
•FSSA Service Center sends records to Med

INDIANA ELIGIBILITY MODERNIZATION
Voluntary Community Assistance Network (V-CAN)
V-CANUserGuide 19 [e-mail]
2.1. ially relevant to agencies
Internet browser’
the screening or
ed when completing an
number, starting with a
e Interview and 2032
Pending Verification notices.
oDo not use the “2400” application (State Form 30465) once the new system is implemented in
your county.
oYou may continue to use Hoosier Healthwise and Medicare Savings Program (QMB / SLMB / QI)
paper applications in the new system.
12 Application Tips
Highlighted below are a few tips and procedures, most of which are espec
involved as Authorized Representatives:
oWhen using the Internet Screening or Online Application, do not use the
“Back” button; instead, use the “back” button located at the bottom of
application.
oThe 10-digit Confirmation Number, starting with a “5,” should only be us
online application that is already in progress. The Case Number (10-digit
“1”) is assigned once an application is submitted and will be listed on th

INDIANA ELIGIBILITY MODERNIZATION
Voluntary Community Assistance Network (V-CAN)
V-CANUserGuide 20 [e-mail]
3. Managing Benefits in the New System
Managing Benefits Overview
There are new ways to manage be
3.1
nefits in the new system, such as checking case status, reporting
ng the redetermination process. The Call Center Main Menu options are also
k with a Call Center
3.1.
lient has been approved
nefits. Or, an agency may wish to check a client’s case status to assist a client, or remind him/her
city, a new
ith a particular
n a single point of entry
and Health Coverage
n file for each agency
rather, an agency will register with the IBM-led Coalition and receive
A client must sign an
cy. Agency staff can
ociated with the agency.
y web portal. By using
enhancement, agency staff will have access to a client’s case status, benefit
rmination date, and a list of pending verifications and due dates, either online or over
rmation about the status of the case and next steps, will be
at have special, legal
Administrators).
IBM-led Coalition at
changes and completi
provided for a quick reference when contacting the Call Center to spea
Representative or to use the automated system.
1 Agency Registration (New!)
Agencies working with public assistance clients may need to know whether a c
for be
of a step in the application process. For agencies working with clients in this capa
enhancement has been developed to provide case status for all clients working w
agency. Agency Registration offers agencies registered with the IBM-led Coalitio
to access case status for clients receiving Food Stamps, Cash Assistance (TANF)
benefits.
Agency Registration does NOT require an Authorized Representative Form to be o
staff member working with a client;
access to client case status, either online or by contacting the FSSA Call Center.
Agency Registration release for their case information to be available to the agen
access an agency-specific web portal to access case status for all clients ass
Each agency is assigned a PIN number to use when accessing the online agenc
the Agency Registration
amount(s), redete
the phone with a Call Center Representative.
Case specific client information, beyond info
provided only to Authorized Representatives or agencies and/or individuals th
authority to access case specific information (i.e., Township Trustees and Section 8
If your agency is interested in the Agency Registration process, please contact the
agencyaccesshel[email protected].
3.1.2 Ch
On sed, applicants, clients
an e automated system,
Int th a Call Center Representative.
Applicants may check case status two weeks after the application is submitted or when the 2032
Pending Verifications notice has been received in the mail by the applicant or Authorized
Representative. The 2032 Pending Verifications notice will provide a 10-digit Indiana Client Eligibility
System (ICES) case number that is used to check case status on the automated system and the Internet.
Checking case status on the Internet
Go to www.in.gov/fssa
ecking Case Status
ce the Indiana Application for Assistance signature page has been proces
d Authorized Representatives may check the application status by using th
ernet or by speaking wi
, click the “Apply for Benefits / Manage Your Benefits” button. Select your
county, then select “Start Here” and the “Check Case Status” link. Applicants must provide last
name, ICES case number, date of birth and last four digits of Social Security Number. The Internet
will indicate if the case is approved, pending or denied. The online case status tool provides the
following case information: